Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.92 / $755.14 / $3,073.00	Facility		$238.92	$755.14	$3,073.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.26 / $75.29 / $247.44	Facility	26	$64.26	$75.29	$247.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.23 / $298.92 / $624.85	Professional		$186.23	$298.92	$624.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.42 / $71.51 / $189.69	Professional	26	$63.42	$71.51	$189.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.21 / $174.80 / $344.58	Professional	TC	$118.21	$174.80	$344.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.22 / $319.37 / $449.15	Professional		$146.22	$319.37	$449.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.00 / $121.34 / $154.47	Professional	26	$70.00	$121.34	$154.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $141.02 / $201.40 / $294.64	Professional	TC	$141.02	$201.40	$294.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,366.89 / $1,366.89 / $1,366.89	Facility		$1,366.89	$1,366.89	$1,366.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.20 / $337.96 / $633.96	Professional		$181.20	$337.96	$633.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.97 / $111.57 / $215.49	Professional	26	$64.97	$111.57	$215.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.35 / $228.37 / $430.71	Professional	TC	$122.35	$228.37	$430.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.06 / $155.94 / $263.20	Facility		$83.06	$155.94	$263.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.58 / $139.82 / $246.08	Professional		$67.58	$139.82	$246.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.59 / $359.26 / $428.69	Facility		$219.59	$359.26	$428.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $128.27	Facility	26	$78.01	$78.01	$128.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.22 / $339.24 / $599.71	Professional		$222.22	$339.24	$599.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.90 / $102.03 / $197.36	Professional	26	$75.90	$102.03	$197.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.11 / $234.95 / $418.48	Professional	TC	$146.11	$234.95	$418.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.18 / $244.15 / $698.75	Professional		$177.18	$244.15	$698.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $72.01 / $94.26 / $187.95	Professional	26	$72.01	$94.26	$187.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.59 / $172.02 / $510.80	Professional	TC	$134.59	$172.02	$510.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $799.76 / $911.77 / $1,100.01	Facility		$799.76	$911.77	$1,100.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.82 / $212.89 / $369.56	Professional		$104.82	$212.89	$369.56
United Facility/Professional Professional Modifier Low / Median / High Price $196.39 / $300.61 / $556.51	Professional		$196.39	$300.61	$556.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.18 / $99.12 / $202.53	Professional	26	$70.18	$99.12	$202.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.60 / $222.56 / $373.62	Professional	TC	$129.60	$222.56	$373.62